HLTENN013 Implement and monitor care of the older person PDF

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Complete assignment of unit HLTENN013 belongs to Diploma of Nursing course...

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HLTENN013 Implement and monitor care of the older person

HLT54115 Diploma of Nursing

TASK 1- QUESTIONING 1. List 5 chronic aged related health problems:  Dementia  Incontinence  Impaired hearing  Mobility loss  Oral health Explain the impact of multiple diagnosis in identifying and prioritizing care of older clients in health care settings: Incontinence: would be the first prioritizing order which has a significant impact on the quality of life of the older and a burden on carers in health care facilities as well. Older people can have urine or faeces incontinence, those things put those people at risks of health issues related to physical and emotional aspects. For example, the leakage of urine can increase the risk of falling and make the person feel embarrassed that may lead to socially isolated. Moreover, the cost of continence aids might be a financial burden. Oral health: might be the second place when it is directly influenced the risks of under nutrition for older people. Therefore, it is a factor affecting overall health and wellbeing. Poor oral health leads to poor dietary intake and weight loss. It is more important when the older people are getting sick because it makes recovery slowly. Besides, poor oral health affects those people’s appearance and their ability to communicate. Reduced mobility: would the third prioritizing order of care in health care settings. It increases the risks of physical injuries for the older people, thus it may lead to inactivity and other health problems. So far, people with reduced mobility are required care frequently. Dementia: might be the next place in the prioritizing list. Dementia is affecting elders’ memory, behavior and their abilities to do daily tasks. People with dementia are often confused and mostly remember what happening in the past. So far, they need to be assisted in normal life. Dementia also increases the risks of other health problems for elders such as hearing loss, stroke, sleep problem, difficult walking, injuries cause of falling and so on. Hearing Loss: would be in the last order. Age-related hearing loss might lead older people to become depressed. Because people with hearing loss can be confused while they can’t hear and respond or cooperate with others. Besides there is no treatment for majority types of hearing loss. However, people with hearing loss can use hearing aids to support them. Victoria State Government, (n.d), Continence and ageing, Health Vic, Retrieved 2017 November 21 from https://www2.health.vic.gov.au/hospitals-and-health-services/patient-care/olderpeople/continence/continence-and-ageing# Government of South Australia, (n.d), Why oral health care is important for older people, SA Health, Retrieved 2018 November 21 from https://www.sahealth.sa.gov.au/wps/wcm/connect/Public+Content/SA+Health+Internet/Clinical+resourc es/Clinical+topics/Oral+health+care+for+older+people/Why+oral+health+care+is+important+for+older +people Health in Aging, (2017 September), Dementia, Retrieved 2018 November 10 from http://www.healthinaging.org/aging-and-health-a-to-z/topic:dementia/info:unique-to-older-adults/

HLTENN013 Implement and monitor care of the older person

HLT54115 Diploma of Nursing

Dementia Australia, (n.d), What is Dementia, Retrieved 2018 November 10 from https://www.dementia.org.au/about-dementia/what-is-dementia National Institute on Aging, (n.d), Hearing Loss: A Common Problem for Older Adults, Retrieved 2018 November 20 from https://www.nia.nih.gov/health/hearing-loss-common-problem-older-adults 2. The importance of oral hygiene for a partial or fully edentulous clients: Oral health is related to general health and well-being of people, especially people with edentulous. Oral hygiene affects the quality of life and the risks of other disease as well. For example, people with poor oral health might have bad breath, painful when eating, difficult in swallowing and ability to maintain enough nutrition for their healthy body. Moreover, poor oral health can impact on general health relating to infection, aspiratory disease, cardiovascular disease. Therefore, taking care well oral hygiene for those clients with edentulous is important to ensure their general health and well-being. Particularly, it is significant to keep the clients’ natural teeth if they are partial edentulous. The care of soft tissues, dentures and dental prosthetics: Brush morning and night Use the soft tooth brush for soft tissues Brush the tongue from back to front carefully Ensure older people don’t wear dentures all the time, especially sleeping time Regularly check the dentures and dental prosthetics status Clean dentures with denture brush and soap carefully and sink them in a bowl of water to clean Store cleaned dentures in cold water with the owners’ name Clean and rinse the brush well 3. What are the external factors and common stereotypes associated with aging and how does it adversely impact the older person? Invisibility: older people may feel they are a burden for their families, friends and societies. Sometimes they feel being ignored by others because people don’t spend their time to talk, communicate or serve the older people as much as they expect. So far, this factor leads older people to experience age-related discrimination because older people’s views, opinions are not considered. It can result in negative emotions in the elderly. Social capability: older people might be unhappy, grumpy and anxiety which might lead to lower interact with others or community. Some older people with disability, living in remote locations, living by themselves, poor health are at more risks to feel isolation. Older people become lonely and they don’t want to seek help from others and community. Overtime, they lose their connections with society. Productivity: older people are likely losing their jobs or don’t involve in workforce. Older people are at risks of financial drain over time. It impacts on their accesses to many services in life and ability to remain the quality of life. Cota Queensland, (n.d), Respect and Social Inclusion, Retrieved 2018 December from https://cotaqld.org.au/achieving_change/age-friendly-queensland/respect-and-social-inclusion-2/ Australian Human Rights Commission, (2013), Fact or fiction? Stereotypes of older Australians, Retrieved from https://www.humanrights.gov.au/sites/default/files/document/publication/Fact%20or %20Fiction_2013_WebVersion_FINAL_0.pdf 4. List the roles and responsibilities of an EN while providing care for a deceased person:

HLTENN013 Implement and monitor care of the older person

HLT54115 Diploma of Nursing

 Inform the doctor and ring the family  Prepare the environment where the deceased is laying before the family enter  Prepare the body: treat the body with dignity and respect, make the body neat and tidy. For example: Lay the body and straight the limbs; Clean the body; Close the eyes; Make the body hair tidy in what the person preferred when he or she lived  Standard precautions to staff and family if there is any disease  Remain calm 5. List 5 functional assessment tools for assessing older clients:  Self-care functional screen: walking, bathing, feeding, using toilet  Domestic functional screen: making phone call, shopping, housekeeping, doing laundry, transportation, managing finances  Behavioral assessment: wandering, physically aggressive, emotional dependence, danger, verbally noisy  Cognitive assessment: language impairment, ability to understand and remember new information, reducing emotional control  Fall assessment: history of falls within the last 12 months, at risk of falling, difficulty with walking or balance Queensland Health, (2002 September), Functional Screening and Assessment: How and Why, Retrieved 2018 November 27 from https://ahsri.uow.edu.au/content/groups/public/@web/@chsd/documents/doc/uow082274.pdf 6. List the limitations and legal ramifications of the following restraints: Restraints 1. Physical restraint

2. Chemical restraint

3. Psychological restraint

Limitations The wrong use of restraints is dangerous for the patient and might cause injuries such as falls, skin tears, psychological effects (fear, depression); in the worst case the physical restraint might result in death. The use of medications to sedate or control patient’s behavior increase the risks of memory loss, muscle disorders, misbehaving, low blood pressure Psychological restraints might be a part of the treatment or care plan when telling to prevent patients from participating in certain activities.

Legal ramifications When restraints are necessary to protect patients from injuries, so any form of restraints must be managed well and considered to less restrict the patient as it can. Medications are used to treat illnesses and protect the safety of patients

Psychological restraints such as therapeutic programs might be used while a patient put him/herself and others at risks.

HLTENN013 Implement and monitor care of the older person

HLT54115 Diploma of Nursing

Morris, B. (2012, October), Chemical restraint of people with disabilities and elderly people, Right Now, Retrieved 2018 November from http://rightnow.org.au/opinion-3/chemical-restraint-of-people-withdisabilities-and-elderly-people/ New South Wales Government, (2015 January), Physical Restraints, Health South Western Sydney Local Health District. Mitchell, G. (2015 November 5), Restraint in Dementia Care, Blog: Evidence-Based Nursing, Retrieved from https://blogs.bmj.com/ebn/2015/11/05/restraint-in-dementia-care/ 7. List few legal and ethical issues associated while caring older clients with the list of considerations to address such issues: https://onlinelibrary.wiley.com/doi/full/10.1111/scs.12213 8. Aged care Act and Carers recognition 1997 act. Include mandatory reporting laws: The Aged care Act is a legislative framework for funding and regulating aged care services. It allows Government to give financial support to individuals who need age care and the aged care facilities as well. Based on the Act, aging population can receive an accessible and affordable aged care service with high quality. The Carers recognition Act is aiming to raise the awareness and recognition of carers and establish their obligations and responsibilities when proving care such as reporting, consulting. Aged care Act and Carers recognition Act work together to protect the rights of older people and ensure their health and well-being. Particularly, under the Aged care Act, aged care providers take responsibility for reporting any suspicions or allegations of assaults have occurred to residents in aged care facilities. Beside residents, the laws also protect the reporters from any victimized actions. Australian Government Department of Social Service, (2016 April), Carer recognition Act 2010 Guidelines, Retrieved from https://www.dss.gov.au/sites/default/files/documents/05_2016/carer_recognition_act_2010_guidelines_a pril_2016.pdf Australian Government Department of Health, (2017, July 31), Guide for reporting reportable assaults, Aging and Aged Care, Retrieved from https://agedcare.health.gov.au/ensuring-quality/aged-care-qualityand-compliance/guide-for-reporting-reportable-assaults Care Guidance, (2014), Aged Care Act, Retrieved from http://careguidance.com.au/aged-care-act/ 9. ACFI and ResCare QA with its role in residential aged care. Aged Care Funding Instrument The Aged care funding instrument (ACFI) is the mean to calculate the cost for providing care to meet each resident needs. Then Australian Government will pay appropriate subsidy to aged care providers The ACFI includes 12 questions about individual aged care needs, divided into 3 broad domains: activities of daily living, behaviour and complex health care. Besides, there are other assessments and health diagnoses. Finally, a resident will be in low-care or high-care based on the rating and the fun will be located according to the level of needs high, medium or low. Residential Care Quality Assessment: ResCare QA is as a tool to assess the quality of care and services in residential aged care homes. It collects data on 24 areas of care, dived into 5 domains: Resident health, personal care, resident lifestyle

HLTENN013 Implement and monitor care of the older person

HLT54115 Diploma of Nursing

and Care environment. Based on the results, the agency will provide better information about the quality of aged care homes’ services following the accreditation standards. Australian Government Department of Health, (2016, December 9), Aged Care Funding Instrument (ACFI) User Guide, Aging and Aged Care. Courtney, M., O’Reilly, M., Edwards, H. and Hassall, S. (), Content validity of the ResCareQA: An Australian residential care quality assessment based on resident outcomes, Australian Journal of Advanced Nursing, 28(3). 10. Physical triggers of aggression and challenging behaviours among older clients in aged care:  Fatigue  Discomfort or Pain  Dehydration  Being rushed  Changing in environment Describe how an EN can use techniques of distraction and behavior modification to address and manage behaviours:  

    

Trying to know the reason of such behaviours Working to avoid and reduce the situations can cause those behaviours such as giving pain relief for residents have discomfort or pain, making sure they sleep enough, ensuring they get enough nutrition, giving them drinks and foods regularly… Avoiding touching the residents without their submission Trying to walk along with the residents and giving time for them Environment modifications such as reducing noise, playing favourite music Encouraging the residents to join in entertainment such as dancing, exercises Giving the residents massages

Carer Gateway, (2016 July), Caring for someone with challenging or changing behaviours, Retrieved from https://www.carergateway.gov.au/caring-for-someone-with-changing-or-challenging-behaviours Government of South Australia, (n.d), Challenging behavior strategy, SA Health, Retrieved 2018 December 11 from https://www.sahealth.sa.gov.au/wps/wcm/connect/Public+Content/SA+Health+Internet/Clinical+resources/Clini cal+topics/Challenging+behaviour+strategy 11. Theories of ageing: a) Biological theory: defined aging is the process in which the body’s systems are reducing their functions. The modern biological theories are divided into 2 main categories: Programmed and Damage or theories. They are also known as non-programmed ageing theories which was developed from evolutionary concepts and programmed ageing theories which stated that aging is the final result of human biological mechanism. b) Psychological theory: discussed the impacts and challenges of changes in roles, relationships and status on the older people with different life stages. c) Disengagement theory: created a framework in which people in the elderly are involved in the process of withdrawal their roles and relationships from society. This process is expected to benefit society in maintaining stability and order.

HLTENN013 Implement and monitor care of the older person

HLT54115 Diploma of Nursing

d) Social exchange theory: stated that social behavior is the result of an exchange process in which people value their benefits and risks of their social relationships. e) Wear and Tear theory: believed that ageing is the result of the process of cells and tissues wear out. This process is necessary to survive; however, the body cannot function correctly after all. f) Activity theory: suggested that older people should remain their active and engagement with society in order to maintain their social roles and relationships. Therefore, they might create their new hobbies, interests, family’s roles, communities’ roles to keep their positive image. Southern Cross Education Institute, Implement and monitor care of the older person, Pre-reading session 1 12. Discuss the normal physiology of ageing process and its relation to the disease process: a) Sensory: the efficiency of the sensory organs including vision, hearing, taste, smell and touch reduces with age. Therefore, the way older people see, hear, taste and smell will be influenced. Older people may decrease in visual acuity, be high risk of hearing loss and reduce in the pleasure and satisfaction obtain from food. Besides, sensory changes can affect how people respond to touch and pain. All those things make older people feel isolation when increasing dependence on others, reducing ability to communicate and socialize, decreasing mobility. b) Cardiac: reducing in maximum cardiac output, decreasing in the elasticity of the heart’ fibrous tissues can restrict the circulation and damage the cardiac tissue. The reducing in the amount of red blood cells, blood clot may appear in veins, pooling of blood in the veins in the legs because of less exercises are also age-related problems in the cardiac system. Some cardiac disorders such as hypertension, coronary artery disease and heart failure are often common in older people. c) Neurological: brain and center nervous system functions decline with age, the number of nerve cells are usually decreased. Consequently, older people often have short-term memory, decrease in the ability to learn new things, verbal abilities might be affected along with the ability to process information. Some common neurological disorders include strokes, neuropathy, Alzheimer’s disease and Parkinson’s disease. d) Musculoskeletal: with age, bones reduce in density resulting in easily broken. Joints are affected by thinner cartilage, then they become less resilient, flexible and easily damaged. Moreover, joints become stiffer because the connective tissue within ligaments and tendons becomes more rigid and brittle. Muscle mass and elasticity diminish. These components of the musculoskeletal system progressively degenerate, which increases the risk of falls and fractures. Arthritis and osteoarthritis are two of most common age-related musculoskeletal disorders. e) Genitourinary: renal function declines significantly resulting in the decrease in the ability of drugs clearance. There is also increased in kidney problems such as decline in the weight and size of kidneys. Consequently, filtration, reabsorption and secretion are decreasing. Bladder capacity decreases. Then, older people likely need to urinate frequently. The perineal muscles that help regulate the release of urine become weaker that leads to incontinence problems. In men, the prostate gland tends to enlarge with aging. f) Endocrine: levels of most hormones decrease with age especially the production of reproductive hormones. In women, the decrease in estrogen levels leads to menopause. The decline in melatonin is affecting sleeping patterns in elderly. Cause of the reduction of tissues’ functions, their ability to respond to hormonal stimuli is affected. Then the endocrine function generally declines while the hormone receptors are less sensitive.

HLTENN013 Implement and monitor care of the older person

HLT54115 Diploma of Nursing

However, recent study shows that exercises can have positive impact on hormone levels depending on the type and duration of those exercises. g) Integumentary: the skin become more thinner and less elasticity which leads to wrinkles development. Aging skin receives less blood flow which affecting body temperature regulation. Number of glandular activities is decreasing which resulting in dry and itchy skin. In addition, the ability to heal by itself is diminished and may result in high risks of ulcer and infections. Melanin production reduction leads to the growth of grey hair. h) Cancer disorders: The risk of cancer is increased with age because almost body systems’ functions are reducing. The whole of body become weaker, especially the immune system function is declining the capacity to fight with diseases. When the cancer happened, the body tent to fight back together with the medication, but it’s won’t get chance to recover like young people. 13. As an EN, I can provide supports and comfort for the grieving family or car...